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Diarrhea Help

Mosey had diarrhea often during his 9-month battle with cancer and I know it is a common ailment for all dogs. The following article from Healthy Pets provides many helpful tips to prevent, diagnose and treat. Please visit their website for additional resources.

What to Do When Your Dog Gets Diarrhea

by Dr. Becker

I think it’s time for another discussion on how to handle the problem of doggy diarrhea.

If you own a dog, chances are you’ve lived through at least one bout of doggy diarrhea.

It’s not a matter of if it will happen – just when.

When will your dog get diarrhea?

Knowing ahead of time the steps to take when your dog develops diarrhea or loose, watery stools can give you peace of mind when the time comes.

And as we all know, the time will come!

Causes of Diarrhea

There are a lot of reasons dogs develop loose stools. The most common reason is dietary indiscretion, which means your dog ate something she shouldn’t have. This was the cause of all the phone calls and emails to me over the holidays.

During the holidays, when people are cooking and hosting a lot of events that involve food, a really ripe environment is created for the ingestion of new foods dogs have not consumed before.

Sometimes it’s leftovers that cause GI upset. And sometimes, owners don’t even know their dogs have gotten into food.

That was the situation in my home, actually. My dogs were tearing open the garbage bags that we had put outside by the garage. They foraged all afternoon and into the evening on a feast of leftovers and we were clueless until we came upon the mess.

Many dogs spend much of their time sniffing around the house for morsels and tidbits anywhere they can find them, including gas grill grease traps, bathroom garbage cans, bird feeders, bird baths, ornamental ponds, and certainly the garden.

Another cause of diarrhea is a sudden change in a dog’s regular food. Also allergies to certain foods and poor quality dog food in general. I see a lot of kibble-related diarrhea in dogs.

Parasites like giardia can cause intermittent diarrhea. This microscopic parasite causes a wax-and-wane type of diarrhea that just pops up out of the blue. And about the time you think you should call the vet, the stool firms up on its own. You assume all is well – until another bout of diarrhea occurs days or weeks later.

Viral and bacterial infections in the digestive tract can cause diarrhea. So can certain medications such as heartworm preventives.

Even stress can bring about an episode of diarrhea in dogs and puppies. While you may think nothing very eventful is going on in your world, your dog can experience stress over even a slight change in routine. Suddenly you’re looking at a bout of watery doggy poop that seems to have come out of the blue.

Symptoms of Diarrhea (the obvious and not-so-obvious)

The most obvious symptom of diarrhea is when your dog is standing anxiously at the door and needs to get out quickly. Once he’s out he runs urgently to a spot and often passes loose, watery stool.

Or … you’re not around when the urgency hits and you find an accident on the floor when you get home.

A less obvious and often confusing symptom of diarrhea can be when your dog strains to go. It actually looks more like constipation than diarrhea.

Diarrhea upsets the normal rhythm of the muscle contractions in your dog’s intestinal tract. This can give him the sensation that he constantly needs to poop. So even though he’s hunched over and straining, his colon could be empty from repeated bouts of loose stool.

Other symptoms that can go along with diarrhea include fever, lethargy, malaise, loss of appetite, and dehydration.

Most healthy dogs experience an occasional episode of loose stool or diarrhea and it’s done – over with. It resolves all by itself. In this instance the underlying issue is probably something she ate she shouldn’t have, or perhaps stress was the trigger.

But any dog has the potential to become very ill from chronic bouts of diarrhea. Puppies, small dogs, and seniors are at higher risk of dehydration from just one round of explosive diarrhea.

It’s important to make sure that your pet has access to clean drinking water at all times, and encourage your pet to drink if you can.

When to Seek Professional Help

If your dog seems fine after a bout of diarrhea — meaning she’s acting normal, with normal energy – it’s safe to simply keep an eye on her.

But if you notice she’s also sluggish, running a fever or feels warm to the touch, or there’s a change in her behavior, I certainly recommend you contact your vet.

If you see blood in your pet’s stool or she’s weak or shows any other signs of debilitation along with the diarrhea, you should make an appointment with the vet.

If your dog seems fine but is experiencing recurrent bouts of diarrhea, you should make an appointment.

It’s important to bring a sample of your dog’s stool to your appointment, even if it’s watery. Use a plastic baggie and shovel a bit in there to take with you. This will help your vet identify potential underlying causes for the diarrhea.

Home Care for Diarrhea in Healthy Dogs

If your pet is an adult, otherwise healthy, and behaving normally except for the diarrhea, I recommend you withhold food – NOT WATER – for 12 hours.

At the 12-hour mark, offer a bland, fat-free diet. I recommend cooked ground turkey and plain 100 percent pumpkin.

Cook the ground turkey to remove grease and extra fat. And make sure the pumpkin isn’t pie filling, just plain canned or fresh cooked. If you can’t find plain canned pumpkin, substitute cooked sweet potato or even instant mashed potatoes.

This is a different bland diet from the traditional ground beef and rice combination that is often recommended. Even the leanest ground beef contains a lot of fat, and fat can worsen a case of diarrhea.

Rice, even though it’s bland, is very fermentable. Fermenting rice in the colon of a pet with diarrhea tends to increase gassiness. Also, rice tends to just zip right through the GI tract, exiting with the next bout of explosive diarrhea totally undigested.

Because of its large surface area (when compared to kernels of rice), many pets do much better with pureed pumpkin or sweet potato. Even through a bout of diarrhea, it is readily absorbed.

Mix the cooked ground turkey and pumpkin or sweet potato 50-50 in your dog’s bowl. Feed 2 to 3 small meals a day until stools are back to 100 percent, which should happen in about 72 hours.

My favorite all-natural anti-diarrhea remedy is an herb called slippery elm bark. I recommend always having some on hand so when you need it, it’s right there. You don’t have to run to the store.

Slippery elm is safe for puppies, adults, and geriatric dogs and it is completely safe blended with other medications. I recommend about a half teaspoon for each 10 pounds of body weight, mixed into the bland diet twice daily.

I also recommend you add in a good quality pet probiotic once the stool starts to firm.

Feeding a bland diet and supplementing with slippery elm bark is a good plan for about 3 days, at which time your dog’s stool should be back to normal.

If after 3 days the diarrhea hasn’t cleared up, it’s time to check in with your veterinarian.

MoseyLove!

Diane, Mose and Jasper

2.7.15

mosey and me

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Should I Take My Dog The Vet Appointment?

mosey-ft collins 1.9.14

Honestly, this question never occurred to me. A vet appointment without the pet? But the following article from the Dog Cancer Blog poses some interesting thoughts? What if you just need advice? What if your dog is too sick to travel? Our oncologist is a three hour drive from home so Mosey is in the car for six hours on visit days. Do the benefits outweigh the inconvenience? Read below for the reasons your vet really needs to examine your pet in person. And, as always, thank you to the folks at Dog Cancer Blog for their very valuable information:

Don’t Forget Your Dog at the Veterinarian

When booking a new consultation with me, pet Guardians often ask if it is necessary to bring their dog to the appointment. From their point of view, they are often concerned about the stress of the visit on their pet, or maybe the travel itself.

But from my point of view, a consultation without the pet is like a visit to the pediatrician without your toddler. So, yes, you should bring your dog!

In some ways I am happy that someone wants to meet me and listen to the overview of their pet’s cancer and ask questions. Educating yourself about your pet’s cancer is important. But the visit is so much more than hearing about an overview of the how the cancer presents, behaves, treatment options, and prognosis. I also review your pet’s medical record; including previous history, previous tests and the cancer cytology or biopsy report.

But a critical part of the consult is my personal evaluation of your dog.

vet-with-dogFor example, if a mast cell tumor has already been removed, but the surgical margins are narrow or incomplete, I can only discover if a second surgery is possible with a physical exam. I need to see the previous scar on your dog. I may lift the scar, and see if we can remove more tissue.  I may even show the dog to our surgeon so see what she thinks and decide if surgery is even an option. If she says no, I just saved you the time and cost of a consult with the boarded surgeon.

Or, I may feel a small mass already coming back at a scar. If the tumor is back, it changes the recommendations. I only can determine that if I examine and feel the dog in person.

Measuring Is Key

I’ve also had cases where the biopsy report lists a soft tissue sarcoma (STS) as completely removed, but the vet notes the mass was 2 cm and the scar is 3 cm. Well, we need 2 to 3 centimeter margins AROUND the tumor … so a 2 cm STS should have an 8 cm scar. I will literally measure scars to make sure that they are actually as complete as reported on lab reports. If not, it’s unlikely the margins are clean and recurrence may be likely. And if that’s true, we need to know, so we can make the best plan.

I may also need follow up tests, like an ultrasound to monitor progression of an abdominal mass or to get a baseline.

Finding Other Tumors

Just last week, I saw a dog with a mass in the bladder, most likely a tumor called transitional cell carcinoma (TCC), based on the ultrasound at the primary vet. Penelope had the classic signs of TCC – straining to urinate and blood in the urine. The vet said the mass was not in the trigone area, which is great, because then we could remove the tumor with surgery before starting chemo. (Many tumors are in the trigone where all the nerves and the urinary tubes that connect from the kidneys and out the urethra. This area is usually inoperable.)

From the ultrasound at the primary vet, it looked like Penelope was a surgery candidate.

To be safe, I recommended a repeat ultrasound. This time the boarded internist not only saw the mass in the non-trigone area but also a larger mass in the urethra, the tube through which urine flows from the bladder to the outside.

Unfortunately, that discovery meant surgery was definitely not an option. With this new info, I changed my recommendations and we discussed medical management like NSAIDs, chemotherapy, and even a stent to keep her peeing if she gets blocked.

So Penelope’s prognosis and treatment options all changed based on the exam and tests. If she hadn’t been physically present, we might have gone ahead with a surgery that would be unnecessary and not even treat the larger mass.

Finding Metastasis

I may also discover something new on the exam, like an enlarged lymph node. If we aspirate that lymph node and find the cancer has metastasized (spread), it may change the prognosis and recommended diagnostics and treatments. If a cancer has spread to the lymph node, we may need to have it removed, radiated, or it may be the reason we add chemo.

Finding Other Problems

Without the patient, we could also miss other problems, like a fever, an infection, a heart murmur, or a lameness so severe that it changes recommendations.

Just yesterday, I had an appointment with Lady, a 11-year-old Russian Blue Terrier. She came to discuss CyberKnife radiation for her recently discovered aggressive bone lesion in her humerus (shoulder), consistent with osteosarcoma.

CyberKnife is an alternative to amputation, and we typically start with a CT scan of the leg to make sure the bone is structurally strong enough to be a good candidate for it. If the tumor has already destroyed too much bone, it puts the dog at increased risk for fracture even if we kill the tumor cells with high doses of radiation.

But looking at Lady (not her X-rays), I saw that she could barely get up and walk. The family was lifting the 100 lb dog to get up and go outside to relieve herself.

I was worried that her limping and disability wasn’t just because of tumor pain. It could also be neuromuscular disease, orthopedic issues, or worse, bone metastasis. I wasn’t going to do a CT scan (very expensive) and recommend CyberKnife radiation if there was some other major underlying medical issue that prevented her from walking. We had to figure this out, first.

So, during that appointment, I consulted with my surgeon, who looked at Lady and isolated the severe pain to her knees and hips, not just the shoulder with the tumor. X-rays confirmed severe degenerative joint disease and arthritis. Unless that can be helped, removing the tumor with radiation would not help her to walk. Even amputation was out, because a dog with this severe pain wouldn’t be able to recover easily.

This information was really helpful, because now we knew a few things:

  1. We can add pain meds, specifically non-steroidal anti-inflammatory drugs (NSAIDs) to her treatment to help bring her some relief.
  2. Her underlying arthritis is too severe for an amputation.
  3. By treating her arthritis we can improve her comfort and mobility.

Once she is feeling better, THEN we can do a CT scan to see if she is a CyberKnife candidate. She may still be!

Bottom Line: Bring Your Dog

So … will I occasionally do a consult without the dog? Yes I do make exceptions, but it really limits what I can do for the pet and the family if the pet is not there to be evaluated.

Live longer, live well,

Dr. Sue

About the Author: Susan Ettinger, DVM, Dip. ACVIM (Oncology)

Susan Ettinger, DVM. Dip. ACVIM (Oncology) is a veterinarian oncologist at Animal Specialty Center in New York and the co-author of Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. She blogs about dog cancer at http://DogCancerBlog.com.

MoseyLove!

Diane and Mose

4.6.14

mosey and me

Chemo Side Effects Help

Mosey and Zola at Substance 3

Mosey has been back on Palladia for a full month. We received really good news yesterday…at our monthly check up with the oncologist we learned that, not only has the tumor not grown, the tumor has shrunk a tiny bit! We compared x-rays from December and then had the radiologist confirm. We are ecstatic as we did not dare to hope that the tumor would cease to grow for a bit…the icing on the cake was the shrinkage. So we are staying with the Palladia as we think this is what is causing the good prognosis. That means we need to deal with the side effects. Mosey suffers from very soft stools a few times a week. We also learned that there are increased levels of protein in his urine which means yet another drug to counter this condition. The following article from The Dog Cancer Blog offers valuable tips and advice for dealing with side effects from Chemotherapy.

Chemo side effects: What should I do?

by DEMIAN DRESSLER, DVM

 

Chemotherapy does have side effects that need to be considered.  About 5% of these will require your pet to be hospitalized, on the average, and there is a 1% chance of fatal reactions overall with chemotherapy.

Although I have not seen any published data, unpublished estimates on overall risks of any side effect are roughly 25-40%.  This means that about one in three dogs will have some kind of adverse effect, but it could be a mild one.

Some of these milder side effects include loss of appetite, vomiting, and diarrhea.  Other adverse reactions include lowering of white cells (leukopenia, which causes immune system suppression), heart damage, lung damage, kidney injury, anemia, blood clotting problems, liver injury, and others.

Of course, this is a summed list for many different drugs.  A given drug will not have all of these.  You should certainly be aware of side effects with all drugs but particularly Doxorubicin (Adriamycin), cyclophoshamide, prednisolone or prednisone, Lomustine, Palladia,  vincristine, L-asparaginase, and more.

You should ask your veterinarian or oncologist about the specific effects of your dog’s treatment, and what to watch for.

For example, keeping track of body weight is quite important during cancer care.  You may need to increase the amount of calories your dog consumes.  When muscle is lost, the amino acids loss in the body hinder the immune system and the lining of the intestine.

Similarly, it is also important to monitor your dog’s rectal temperature.  The reason for this is that a low white blood cell count can often lead to infection in the body.  Most commonly, infection will produce a fever.  Most chemotherapy drugs used in cancer protocols can cause low white blood cell counts.

If your dog is drooling or smacking his or her lips, it could be a sign of nausea or too much acid in the stomach.  Usually this means we need to temporarily rest the stomach, then go on a special diet, offer antacids like cimetidine, give ginger, and consider branched chain amino acid supplements to help restore stomach or intestinal health.

Keeping an eye on the quality of the stool is vital too.  Many chemo drugs will cause diarrhea.  If this occurs, your vet should also temporarily change to a highly digestible food, and consider using something to help with the diarrhea.  Slippery elm, pepto bismol, kaopectate, or other medications and supplements can all help.

The Dog Cancer Survival Guide has more information about what you can do to help with some of the more serious side effects by giving certain supplements.  Please consult with your veterinarian and the Dog Cancer Survival Guide for proper doses for your individual dog.

Best to all,

Dr D

About the Author: Demian Dressler, DVM

Dr. Demian Dressler, DVM is known as the “dog cancer vet” and is author of Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. Visit his blog and sign up free to get the latest information about canine cancer. Go to http://DogCancerBlog.com.

MoseyLove!

Diane and Mose

2.26.14

mosey and me

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